Cognitive and Emotional Determinants Characterizing Women with Persistent Genital Arousal Disorder

INTRODUCTION: Persistent genital arousal disorder (PGAD) is a relatively unknown clinical condition affecting several women. Moral standards, as well as conservative beliefs regarding sexuality, are believed to be involved in the etiology and maintenance of this syndrome. Nevertheless, there are no consistent data on the content of the beliefs system presented by these women. AIM: The aim of this study was to characterize the cognitive and emotional style of women reporting PGAD. More precisely, the content of sexual beliefs, thoughts, and emotions during sexual intercourse was explored. METHODS: Forty-three women presenting PGAD and 42 controls responded to a web survey. This study was cross-cultural in nature and women worldwide (over 18 years old) were asked to participate. MAIN OUTCOME MEASURES: Participants answered the following online questionnaires: Sexual Dysfunctional Beliefs Questionnaire, Sexual Modes Questionnaire, Positive and Negative Affect Schedule, and Brief Symptom Inventory. Additionally, participants responded to a checklist assessing the presence and frequency of PGAD symptoms. RESULTS: After controlling for sociodemographic characteristics and psychopathology, findings showed that women reporting PGAD symptoms presented significantly more dysfunctional sexual beliefs (e.g., sexual conservatism, sexual desire as a sin), as well as more negative thoughts (e.g., thoughts of sexual abuse and of lack of partner's affection) and dysfunctional affective states (more negative and less positive affect) during sexual activity than non-PGAD women. CONCLUSIONS: Notwithstanding the impact of neurophysiological determinants in the etiology of this syndrome, results support the psychological conceptualization of PGAD and highlight the role of cognitive-behavioral therapy (CBT) for PGAD symptomatology. More specifically, cognitive and behavioral strategies would be aimed at targeting maladaptive sexual beliefs and thoughts, as well as regulating negative affective states resulting from a dysfunctional cognitive style regarding sexuality. In all, CBT in association with a medical/pharmacological approach, could be clinically relevant in the management of PGAD.